Surgical Resection and Reconstruction for Metastatic Spinal Tumors_West China Medical Journal

Authors：

ZHANG Zhi , YE Yongjie , ZHENG Jiazhuang , et al.

Department of Orthopaedics，Suining People’s Hospital，Suining Sichuan 629000，China;

Corresponding author：

Keywords：

脊柱; 肿瘤; 转移; 外科切除; 重建

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目的:探讨脊柱转移瘤患者的手术切除与脊柱稳定性重建的适应证与效果。方法：2003年4月至2008年4月，收治了脊柱转移癌患者32例。肿瘤转移部位:胸椎转移22例，腰椎转移7例，颈椎转移3例。男性13例，女性19例。出现神经系统受损者27例，其中完全瘫痪者7例，不完全瘫痪者20例。全组患者均做了椎体切除、内固定术或后路椎板切除、椎管减压内固定术或前后路联合行360°脊椎切除固定一期重建脊柱稳定性。观察术后局部疼痛缓解，神经功能恢复及脊柱稳定性情况。结果：随访时间为6～60个月，32例患者中，30例术后痛疼得到缓解。27例有神经功能损害的患者中，25例术后麻痹症状改善。3例完全瘫痪的患者中，2例在减压术后ASIA分级提高了1~2个等级。术后影像学提示脊柱序列和椎间高度恢复。术后存活1年以上的患者22例，约占患者总数的69%。结论：外科切除与重建治疗转移癌所致椎体塌陷或不稳定造成严重的神经损害或机械性脊柱痛疼的外科疗效肯定，能够增加脊椎稳定性，提高生存质量。

Citation： ZHANG Zhi,YE Yongjie,ZHENG Jiazhuang,et al.. Surgical Resection and Reconstruction for Metastatic Spinal Tumors. West China Medical Journal, 2009, 24(1): 90-93. doi: Copy

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10.	Boriani S，Biagini R，De Iure F，et al.En bloc resections of bone tumors of the thoracolumbar spine.A preliminary report on 29 patients[J].Spine，1996，21（16）:1927-1931.

1. Weigel B，Maghsudi M，Neumann C，et al.Surgical management of symptomatic spinal metastases.Postoperative outcome and quality of life[J].Spine，1999，24:2240-2246..
2. FeizErfan I，Rhines LD，Weinberg JS.The role of surgery in the management of metastatic spinal tumors[J].Semin Oncol，2008，35（2）:108-117..
3. Fujimaki Y，Tsuchiya H，Kawahara N，et al.Surgical treatment for metastatic bone tumor[J].Clin Calcium，2006，16（4）:647-654..
4. Manabe J，Kawaguchi N，Matsumoto S，et al.Surgical treatment of bone metastasis:indications and outcomes[J].Int J Clin Oncol，2005，10（2）:103-111..
5. Bilsky MH，Boakye M，Collignon F，et al.Operative management of metastatic and malignant primary subaxial cervical tumors[J].J Neurosurg Spine，2005，2（3）:256-264..
6. Chen YJ，Hsu HC，Chen KH，et al.Transpedicular partial corpectomy without anterior vertebral reconstruction in thoracic spinal metastases[J].Spine，2007 Oct 15；32（22）:E6236..
7. 刘忠军，党耕町，马庆军，等.脊柱肿瘤的全脊椎切除术及脊柱稳定性重建[J].中华骨科杂志，2001，21（11）:646-649..
8. Vrionis FD，Small J.Surgical management of metastatic spinal neoplasms[J].Neurosurg Focus，2003，15（5）:E12..
9. Tomita K，Kawahara N，Kobayashi T，et al.Surgical strategy for spinal metastases[J].Spine，2001，26:298-306..
10. Boriani S，Biagini R，De Iure F，et al.En bloc resections of bone tumors of the thoracolumbar spine.A preliminary report on 29 patients[J].Spine，1996，21（16）:1927-1931.

West China Medical Journal

Surgical Resection and Reconstruction for Metastatic Spinal Tumors

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